BiPAP无创通气对急性左心衰竭患者氧合指数及血清和肽素水平的影响
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摘要
目的:探讨双水平呼吸道正压(BiPAP)无创通气对急性左心衰竭(ALHF)患者氧合指数(PaO_2/FiO_2)及血清和肽素(Copeptin)水平的影响及临床意义。方法:选取2015-10—2018-03期间本院急诊收治的ALHF患者120例,随机分为治疗组(BiPAP加常规治疗)和对照组(常规治疗)各60例,记录两组患者治疗前、治疗后3 d、治疗后7 d的PaO_2/FiO_2及血清Copeptin水平。结果:治疗组总有效率93.3%,高于对照组的80%(P<0.05)。治疗组及对照组开始治疗前一般资料比较差异无统计学意义(P>0.05);治疗后3 d及治疗后7 d,两组PaO_2/FiO_2均有改善,血清Copeptin水平较前明显下降,且治疗组变化更明显(均P<0.05)。结论:在常规治疗的基础上使用BiPAP,能更加有效地提高ALHF患者的PaO_2/FiO_2,降低血清Copeptin水平,改善心功能。
Objective:To investigate the effect of bi-level positive airway pressure(BiPAP) non-invasive ventilation on the levels of oxygenation index(PaO_2/FiO_2)and Copeptin in patients with acute left heart failure(ALHF)and its clinical significance. Method:One hundred and twenty patients with ALHF from October 2015 to March 2018 were randomly divided into treatment group(BiPAP plus routine treatment)and control group(routine treatment) with 60 cases each.PaO_2/FiO_2and Copeptin level of the two groups were recorded before treatment,3 days after treatment,7 days after treatment. Result:The total effective rate of the treatment group was 93.3%,which was higher than that of the control group(80%)(P<0.05).There was no significant difference between the two groups before the treatment(P>0.05).After 3 days and 7 days of treatment,the two groups of PaO_2/FiO_2 were improved,the Copeptin level was significantly lower than that before,and the changes in the treatment group were more obvious(P<0.05).Conclusion:The use of BiPAP on the basis of routine treatment can improve the PaO_2/FiO_2 of ALHF patients more effectively,reduce the level of Copeptin and improve the cardiac function.
Objective:To investigate the effect of bi-level positive airway pressure(BiPAP) non-invasive ventilation on the levels of oxygenation index(PaO_2/FiO_2)and Copeptin in patients with acute left heart failure(ALHF)and its clinical significance. Method:One hundred and twenty patients with ALHF from October 2015 to March 2018 were randomly divided into treatment group(BiPAP plus routine treatment)and control group(routine treatment) with 60 cases each.PaO_2/FiO_2and Copeptin level of the two groups were recorded before treatment,3 days after treatment,7 days after treatment. Result:The total effective rate of the treatment group was 93.3%,which was higher than that of the control group(80%)(P<0.05).There was no significant difference between the two groups before the treatment(P>0.05).After 3 days and 7 days of treatment,the two groups of PaO_2/FiO_2 were improved,the Copeptin level was significantly lower than that before,and the changes in the treatment group were more obvious(P<0.05).Conclusion:The use of BiPAP on the basis of routine treatment can improve the PaO_2/FiO_2 of ALHF patients more effectively,reduce the level of Copeptin and improve the cardiac function.
引文
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[6] 王灵,王万灵,王振华,等.氧合指数在急性左心衰竭中的应用价值[J].中国全科医学,2016,19(5):595-598.
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[2] 陈丽萍,姚亚宾.急性心力衰竭急救后的生存获益研究[J].临床急诊杂志,2016,17(3):217-219,223.
[3] 肖昌玉,张虹,袁艺.BiPAP无创通气用于急诊治疗重度哮喘对患者肺功能的影响情况分析[J].临床急诊杂志,2017,18(1):48-50,54.
[4] 周斌,余平,典万康.无创呼吸机对脑出血伴有呼吸衰竭患者的救治效果及血气指标变化影响[J].临床急诊杂志,2016,17(12):966-968.
[5] 陶新,张超,高洁.Copeptin联合pro-BNP在BiPAP治疗急性心力衰竭中的意义[J].临床急诊杂志,2018,19(8):533-536.
[6] 王灵,王万灵,王振华,等.氧合指数在急性左心衰竭中的应用价值[J].中国全科医学,2016,19(5):595-598.
[7] Maisel A,Xue Y,Shah K,et al.Increased 90-day mortality in patients with acute heart failure with elevated copeptin:secondary results from the Biomarkers in Acute Heart Failure(BACH)study[J].Circ Heart Fail,2011,4(5):613-620.